Organization
ACCESS LASER & VEIN CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ICASIANO BS, RVS (CHIEF FINANCIAL OFFICER)
(707) 334-1704
Entity
Organization
Contact information
Practice address
333 SUNSET AVE STE 140, SUISUN CITY, CA 94585-2054
(707) 334-1704
Mailing address
333 SUNSET AVE STE 140, SUISUN CITY, CA 94585-2054
(707) 334-1704
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
112626
CA
Other
Enumeration date
09/19/2015
Last updated
09/19/2015
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